EP4358864A1 - Buttress attachment for surgical stapling apparatus - Google Patents

Buttress attachment for surgical stapling apparatus

Info

Publication number
EP4358864A1
EP4358864A1 EP22740961.2A EP22740961A EP4358864A1 EP 4358864 A1 EP4358864 A1 EP 4358864A1 EP 22740961 A EP22740961 A EP 22740961A EP 4358864 A1 EP4358864 A1 EP 4358864A1
Authority
EP
European Patent Office
Prior art keywords
end portion
buttress
surgical
staple cartridge
protrusion
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
EP22740961.2A
Other languages
German (de)
French (fr)
Inventor
Jacob C. Baril
Roanit FERNANDES
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Covidien LP
Original Assignee
Covidien LP
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Covidien LP filed Critical Covidien LP
Publication of EP4358864A1 publication Critical patent/EP4358864A1/en
Pending legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/0682—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil
    • A61B17/0686—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil having a forming anvil staying below the tissue during stapling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07292—Reinforcements for staple line, e.g. pledgets
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07257—Stapler heads characterised by its anvil
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07271—Stapler heads characterised by its cartridge

Definitions

  • the present application is generally related to surgical stapling apparatus, and more particularly, to surgical buttress attachment assemblies for releasably securing surgical buttresses to the surgical stapling apparatus.
  • Surgical stapling apparatus are employed by surgeons to sequentially or simultaneously apply one or more rows of fasteners, e.g., staples or two-part fasteners, to body tissue for the purpose of joining segments of body tissue together.
  • Such apparatus generally include a pair of jaws or finger-like structures between which the body tissue to be joined is placed.
  • longitudinally moving firing bars contact staple drive members in one of the jaws.
  • the staple drive members push the surgical staples through the body tissue and into an anvil in the opposite jaw which forms the staples.
  • a knife blade can be provided in the jaws of the apparatus to cut the body tissue between the lines of staples.
  • Surgical supports e.g., meshes or buttress materials
  • surgical stapling apparatus may be used in combination with surgical stapling apparatus to bridge, repair, and/or reinforce tissue defects within a patient.
  • a clinician may manually attach the buttress materials to the surgical stapling apparatus in the operating room during a surgical procedure, or utilize a surgical stapling apparatus including buttress materials pre-installed thereon, e.g., by an expensive automated attachment process.
  • the buttress material reinforces the staple or suture line as well as covers the juncture of the body tissues to reduce leakage prior to healing.
  • the present disclosure relates to buttress material attachment onto a surgical stapling apparatus.
  • Surgical buttress attachment assemblies of this disclosure are designed to make surgical buttress attachment in the operating room a simple, straightforward, and cost-effective procedure.
  • the present disclosure provides a surgical stapling apparatus including a loading unit, a surgical buttress, and a buttress retention band.
  • the loading unit includes an anvil assembly and a staple cartridge assembly.
  • the staple cartridge assembly includes a staple cartridge having a tissue facing surface including staple pockets and a central longitudinal slot defined therethrough, and a protrusion extending outwardly therefrom.
  • the surgical buttress includes a proximal end portion and a distal end portion.
  • the proximal end portion is positioned over the protrusion of the staple cartridge.
  • the buttress retention band is disposed around the proximal end portion of the surgical buttress and the protrusion of the staple cartridge to releasably secure the proximal end portion of the surgical buttress to the staple cartridge assembly.
  • the protrusion of the staple cartridge may be disposed proximal to the staple pockets defined in the tissue facing surface of the staple cartridge.
  • the protrusion may include sidewalls extending outwardly from the tissue facing surface and a platform raised off the tissue facing surface.
  • the proximal end portion of the surgical buttress has a width that is the same as a width of the platform of the protrusion.
  • the protrusion may include a groove extending around a periphery thereof, and the buttress retention band may be disposed within the groove.
  • the protrusion may have a split body including first and second body halves disposed on opposed sides of the central longitudinal slot of the staple cartridge.
  • the proximal end portion of the surgical buttress may be a tab extending proximally from a body of the surgical buttress.
  • the distal end portion of the surgical buttress may be a pocket extending distally from a body of the surgical buttress, and the staple cartridge may include a cartridge tip disposed within the pocket to releasably secure the distal end portion of the surgical buttress to the staple cartridge assembly.
  • the pocket may include perforations defined therein. The perforations may be aligned with the central longitudinal slot of the staple cartridge.
  • the buttress retention band may include an elongate body having first and second ends.
  • the first end may be slidably coupled onto the elongate body to form a loop encircling the proximal end portion of the surgical buttress and the protrusion of the staple cartridge.
  • the first end of the elongate body may include an aperture through which the second end of the elongate body is threaded.
  • the elongate body may include barbs.
  • the buttress retention band may be threaded through the proximal end portion of the surgical buttress to form a loop around the proximal end portion.
  • the anvil assembly may include an anvil plate having a tissue facing surface including staple forming pockets and a central longitudinal slot defined therethrough, and a protrusion extending outwardly therefrom.
  • the surgical stapling apparatus further includes a second surgical buttress and a second buttress retention band.
  • the second surgical buttress includes a proximal end portion and a distal end portion. The proximal end portion is positioned over the protrusion of the anvil plate.
  • the second buttress retention band is disposed around the proximal end portion of the second surgical buttress and the protrusion of the anvil plate to releasably secure the proximal end portion of the second surgical buttress to the anvil assembly.
  • the protrusions of the anvil and staple cartridge assemblies may be disposed proximal to the staple forming pockets and the staple pockets.
  • the distal end portion of the second surgical buttress may include a pocket, and the anvil assembly may include an anvil tip disposed within the pocket to releasably secure the distal end portion of the second surgical buttress to the anvil assembly.
  • this disclosure provides a surgical buttress attachment assembly including a staple cartridge, a surgical buttress, and a buttress retention band.
  • the staple cartridge has a tissue facing surface including staple pockets and a central longitudinal slot defined therethrough, and a protrusion extending outwardly therefrom.
  • the surgical buttress includes a proximal end portion and a distal end portion. The proximal end portion is positioned over the protrusion of the staple cartridge.
  • the buttress retention band is disposed around the proximal end portion of the surgical buttress and the protrusion of the staple cartridge to releasably secure the proximal end portion of the surgical buttress to the staple cartridge.
  • the distal end portion of the surgical buttress may include a pocket and the staple cartridge may include a cartridge tip disposed within the pocket to releasably secure the distal end portion of the surgical buttress to the staple cartridge.
  • FIG. 1 is a perspective view of a surgical stapling apparatus in accordance with an aspect of the present disclosure
  • FIG. 2 is a close-up view of the area of detail 2 indicated in FIG. 1, showing a tool assembly of the surgical stapling apparatus;
  • FIG. 3 is a perspective view, with parts separated, of a surgical buttress attachment assembly including a surgical buttress, a buttress retention band, and a staple cartridge assembly of the surgical stapling apparatus of FIG. 1 ;
  • FIG. 4 is a close-up view of the area of detail 4 indicated in FIG. 3, showing a proximal end portion of the staple cartridge assembly;
  • FIG. 5 is a cross-sectional view of the surgical buttress of FIG. 3, taken along section line 5-5 of FIG. 3;
  • FIG. 6 is a front view of the buttress retention band of FIG. 3;
  • FIG. 7 is a perspective view of a proximal end portion of the staple cartridge assembly of FIG. 3, shown with the surgical buttress secured to the staple cartridge by the buttress retention band;
  • FIG. 8 is a perspective view of the proximal end portion of the staple cartridge assembly of FIG. 7, shown during a firing stroke of the surgical stapling apparatus;
  • FIG. 9 is a perspective view of a surgical buttress and a buttress retention band in accordance with another aspect of the present disclosure.
  • FIG. 10 is a bottom, perspective view of a surgical buttress attachment assembly including a surgical buttress, a buttress retention band, and an anvil assembly in accordance with another aspect of the present disclosure.
  • proximal refers to a portion of a structure, or component thereof, that is closer to a user
  • distal refers to a portion of the structure, or component thereof, that is farther from the user.
  • the surgical stapling apparatus 1 generally includes a handle assembly 10, an elongate tubular body 20 extending distally from the handle assembly 10, and a loading unit 30 extending distally from the elongate tubular body 20.
  • the loading unit 30 includes a housing portion 32 and a tool or jaw assembly 34 including first and second jaw members 34a, 34b.
  • the first jaw member 34a and/or the second jaw members 34b is pivotable with respect to the housing portion 32 such that the tool assembly 34 is movable between an open position in which the first and second jaw members 34a, 34b are spaced apart with respect to each other, and a closed position in which the first and second jaw members 34a, 34b are substantially adjacent each other.
  • the handle assembly 10 includes a stationary handle member 12a, a movable handle member 12b, and a barrel portion 14. Actuation of the movable handle member 12b applies lines of staples to tissue captured between the first and second jaw members 34a, 34b of the tool assembly 34.
  • An articulation lever 16 is mounted on the forward end of the barrel portion 14 to facilitate articulation of the tool assembly 34.
  • a rotatable member 18 is also mounted on the forward end of the barrel portion 14, adjacent the articulation lever 16. Rotation of the rotatable member 18 relative to the barrel portion 14 rotates the elongate tubular body 20 and the loading unit 30 relative to the handle assembly 10 so as to properly orient the tool assembly 34 relative to tissue to be stapled.
  • a knob 19 is movably positionable along the barrel portion 14.
  • the knob 19 is advanced distally to approximate or close the first and second jaw members 34a, 34b of the tool assembly 34 relative to each other, and retracted proximally to unapproximate or open the first and second jaw members 34a, 34b of the tool assembly 34 with respect to each other.
  • the loading unit 30 is a disposable loading unit (“DLU”) that is releasably secured to the elongated tubular body 20 and thus, replaceable with a new loading unit 30.
  • the loading unit 30 may be a single use loading unit (“SULU”) that is used one time and then replaced to facilitate multiples uses of the surgical stapling apparatus 1 on a patient. For example, during a surgical procedure, the surgical stapling apparatus 1 can be used to staple and cut tissue, and the entire SULU is replaced after each staple and cut operation of the surgical stapling apparatus 1.
  • the loading unit 30 may be a multi-use loading unit (“MULU”) that is re-useable a predetermined number of times.
  • MULU multi-use loading unit
  • the surgical stapling apparatus 1 can be used to staple and cut tissue, and a reload assembly (e.g., a staple cartridge 54 as seen in FIG. 2) of the MULU is replaced after each staple and cut operation of the surgical stapling apparatus 1 a pre-determined number of times before the entire MULU needs to be replaced.
  • a reload assembly e.g., a staple cartridge 54 as seen in FIG. 2
  • the loading unit 30 may be permanently affixed to the elongated tubular body 20.
  • the first jaw member 34a of the tool assembly 34 includes an anvil assembly 40 and the second jaw member 34b of the tool assembly 34 includes a staple cartridge assembly 50.
  • the anvil assembly 40 includes an anvil plate 42 and a cover plate 44 secured over the anvil plate 42.
  • the staple cartridge assembly 50 includes a cartridge carrier 52 and a staple cartridge 54 selectively received and supported within the cartridge carrier 52.
  • the staple cartridge 54 may be removably and/or replaceably attached to the cartridge carrier 52 by, for example, a snap-fit connection, a detent, a latch, among other types of connectors within the purview of those skilled in the art.
  • laparoscopic or open staplers such as, for example, GIATM, Endo GIATM, TATM, and Endo TATM staplers and/or linear and radial reloads with, for example, Tri-StapleTM technology, available through Medtronic (North Haven, CT) may be utilized with aspects of the present disclosure.
  • FIG. 3 a surgical buttress attachment assembly 2 of the surgical stapling apparatus 1 (FIG. 1) is shown.
  • the surgical buttress attachment assembly 2 includes the staple cartridge assembly 50, a surgical buttress 70, and a buttress retention band 80.
  • the staple cartridge 54 of the staple cartridge assembly 50 includes a cartridge body 56 having an inward or tissue facing surface 58 defining staple pockets or retention slots 55 formed therein.
  • a central longitudinal slot 57 is formed in and extends along a substantial length of the cartridge body 56 to facilitate passage of a knife blade 24 (FIG. 8) of a drive assembly 22 therethrough.
  • a cartridge tip 60 extends axially from the cartridge body 56 distal to the staple pockets 55 and a protrusion 62 extends outwardly from the tissue facing surface 58 of the cartridge body 56 proximal to the staple pockets 55.
  • the protrusion 62 is a projection, bump, protuberance, etc. on the tissue facing surface 58 of the staple cartridge 54 to which a proximal end portion 70a of the surgical buttress 70 is releasably secured via the buttress retention band 80.
  • the protrusion 62 has a split body including first and second body halves 62a, 62b disposed on opposed sides of the central longitudinal slot 57 of the staple cartridge 54 so that the protrusion 62 does not encumber travel of the knife blade 24 (FIG. 8) during a firing stroke of the surgical stapling apparatus 1 (FIG. 1).
  • the protrusion 62 includes side walls 64 extending outwardly from the tissue facing surface 58 of the staple cartridge 54 towards the anvil assembly 40 (FIG. 2) and a platform 66 raised off of the tissue facing surface 58 and extending along a plane parallel to a plane defined by the tissue facing surface 58.
  • a groove 65 is defined in the side walls 64 and extends around a periphery of the protrusion 62 (e.g., circumferentially therearound).
  • the surgical buttress 70 includes a body 72 having a generally rectangular shape that is configured for positioning over the staple pockets 55 of the tissue facing surface 58 of the staple cartridge 54.
  • a proximal end portion 70a of the surgical buttress 70 includes a tab 74 and a distal end portion 70b of the surgical buttress 70 includes a pocket 76.
  • the tab 74 extends proximally from a proximal end 72a of the body 72 and is sized and shaped for positioning over the protrusion 62 on the tissue facing surface 58 of the staple cartridge 54.
  • the tab 74 has a width that is smaller than a width of the body 72 and, in some aspects, the tab 74 has a width that is substantially the same as a width of the protrusion 62 of the staple cartridge 54. In aspects, the tab 74 has a length that is longer than a length of the protrusion 62 such that the tab 74 covers the protrusion 62 along the length thereof.
  • the pocket 76 extends distally from a distal end 72b of the body 72 and is sized and shaped for positioning around the cartridge tip 60 of the staple cartridge 54.
  • the pocket 76 has a proximally facing opening into a cavity 77 defined therein for receiving the cartridge tip 60.
  • Perforations 79 are defined in the pocket 76 and extend along a plane coincident with the central longitudinal slot 57 of the staple cartridge 54 when the surgical buttress 70 is disposed on the staple cartridge assembly 50.
  • the perforations 79 are disposed distal to the central longitudinal slot 57 of the staple cartridge 54 (e.g., only in the pocket 76 of the surgical buttress 70) and, in some other aspects, the perforations 79 are further defined in the body 72 of the surgical buttress 70 (e.g., in the distal end 72b of the body 72) and overlie a portion of the central longitudinal slot 57.
  • the surgical buttress 70 is fabricated from biocompatible materials which are bioabsorbable or non-absorbable, natural or synthetic materials. It should be understood that a single or combination of natural, synthetic, bioabsorbable, and/or non-bioabsorbable materials may be used to form the surgical buttress 70. In aspects, the surgical buttress 70 is a single sheet of material that is formed and cut to shape.
  • the surgical buttress 70 is formed from a plurality of sheets of material, that are fabricated from the same or different materials, and/or the components (e.g., the body, the tab, the pocket, etc.) of the surgical buttress 70 are formed from the same or different materials that are attached to one another by, for example, welding, using adhesive, tying sutures, etc.
  • the surgical buttress 70 may be porous, non-porous, or combinations thereof. Suitable porous structures include, for example, fibrous structures (e.g., knitted structures, woven structures, and non-woven structures) and/or foams (e.g., open or closed cell foams). Suitable non-porous structures include, for example, films.
  • the surgical buttress 70 may be a single porous or non-porous layer, or include a plurality of layers including any combination of porous and non-porous layers.
  • the surgical buttress 70 may include multiple porous and non-porous layers that are stacked in an alternating manner.
  • the surgical buttress 70 may be formed in a “sandwich-like” manner wherein the outer layers are porous and the inner layer(s) are non-porous, or vice versa.
  • Porous layer(s) in the surgical buttress 70 may enhance the ability of the surgical buttress 70 to absorb fluid, reduce bleeding, and/or seal a wound. Also, the porous layer(s) may allow for tissue ingrowth to fix the surgical buttress 70 in place. Non-porous layer(s) in the surgical buttress 70 may enhance the ability of the surgical buttress 70 to resist tears and perforations during the manufacturing, shipping, handling, and/or stapling processes. Also, non-porous layer(s) may retard or prevent tissue ingrowth from surrounding tissues thereby acting as an adhesion barrier and preventing the formation of unwanted scar tissue.
  • the buttress retention band 80 has an elongate body
  • the elongate body 82 is formed from a length of material (e.g., a single, continuous structure, such as a suture, athread, a fiber, etc. having a monofilament or multifilament construction).
  • the first end 82a of the elongate body 82 is slidably coupled onto the elongate body 82 to form a loop 84 defining an opening 85 therein that is adjustable in size.
  • the first end 82a includes an aperture 83 through which the second end 82b is threaded. The second end 82b can be moved relative to the aperture
  • the loop 84 is configured to encircle and grip the protrusion 62 of the staple cartridge 54.
  • the elongate body 82 includes barbs 86 along a majority thereof, with the first end 82a of the elongate body 82 being barbless to provide a surface to which the barbs 86 adhere and the second end 82b of the elongate body 82 also being barbless to provide a grasping portion for the user.
  • the barbs 86 help facilitate locking of the loop 84 once adjusted to a desired sized and, in aspects, allows for one-way travel of the elongate body 82 through the first end 82a for adjusting the loop 84 to a smaller size.
  • the barbs 86 may be single or compound and may be oriented in a unidirectional or bidirectional arrangement.
  • a barbed suture available commercially as V-LOCTM from Medtronic (North Haven, CT) may be utilized with aspects of the present disclosure .
  • V-LOCTM commercially as Medtronic (North Haven, CT)
  • V-LOCTM Medtronic
  • the buttress retention band may have other barb configurations, such as barbs along portion(s) or the entirety thereof.
  • the buttress retention band may be barbless.
  • the buttress retention band 80 is formed from biocompatible materials which may be any combination of natural, synthetic, bioabsorbable, and/or non-bioabsorbable materials.
  • the buttress retention band 80 is formed from a biodegradable material such that any portion released into the body of a patient (e.g., fragments remaining with the surgical buttress 70 or cut after firing of the surgical stapling apparatus 1) does not need to be retrieved from the patient’s body.
  • the buttress retention band 80 may be formed from an elastic or stretchable material having a pre-formed, continuous loop biased in size to engage the protrusion 62 of the staple cartridge assembly 50, and stretchable during placement on the protrusion 62.
  • the pocket 76 of the surgical buttress 70 is aligned with the cartridge tip 60 of the staple cartridge assembly 50 and slid thereover such that the cartridge tip 60 is received and retained within the cavity 77 defined in the pocket 76 of the surgical buttress 70, as seen in FIG. 2.
  • the body 72 of the surgical buttress 70 is laid against the tissue facing surface 58 of the staple cartridge 54, with the tab 74 of the surgical buttress 70 aligned with and extending across the platform 66 of the protrusion 62 of the staple cartridge 54.
  • buttress retention band 80 is placed over the tab 74 of the surgical buttress 70 with the loop 84 encircling the tab 74 and the protrusion 62.
  • the buttress retention band 80 is then tightened by pulling the second end 82b of the elongate body 82 to adjust the size of the loop 84 and to capture the tab 74 of the surgical buttress 70 onto the projection 62 of the staple cartridge 54, as seen in FIG. 7.
  • buttress retention band 80 is aligned with the groove 65 defined in the protrusion 62 such that the elongate body 82 is fixed within the groove 65 during tightening of the loop 84 to secure the buttress retention band 80 to the tab 74 and the projection 62.
  • the proximal end portion 70a of the surgical buttress 70 is retained on the staple cartridge assembly 50 by engagement of the tab 74 with the protrusion 62 via the buttress retention band 80 (FIG. 7), and the distal end portion 70b of the surgical buttress
  • the surgical stapling apparatus 1 (FIG. 1), with the staple cartridge assembly 50 loaded with the surgical buttress 70, is ready for use.
  • the anvil assembly 40 is pre-loaded and/or loaded with a surgical buttress 71.
  • attachment feature within the purview of those skilled in the art, such as, for example, mechanical attachment features (e.g., a suture as seen in FIG. 2), chemical attachment features (e.g., adhesive), and/or attachment methods (e.g., welding).
  • mechanical attachment features e.g., a suture as seen in FIG. 2
  • chemical attachment features e.g., adhesive
  • attachment methods e.g., welding
  • the surgical stapling apparatus 1 In operation, with the loading unit 30 loaded with the surgical buttress 70, as described above and shown in FIG. 1, the surgical stapling apparatus 1 is used in accordance with methods known by those skilled in the art. Once the anvil and staple cartridge assemblies 40, 50 are clamped onto tissue, the surgical stapling apparatus 1 is fired, thereby stapling the surgical buttress 70 to the tissue. As shown in FIG. 8, during firing, the knife blade 24 of the drive assembly 22, which is defined in a distal edge of an I-beam 26, travels distally through the central longitudinal slot 57 and substantially simultaneously cuts and divides the tissue and the surgical buttress 70 disposed between the rows of formed staples.
  • the knife blade 24 travels through the protrusion 62 and cuts the buttress retention band 80 thereby releasing the tab 74 from the protrusion 62.
  • the surgical buttress 70 which is now stapled to the tissue, pulls away from the staple cartridge assembly 50, and the tool assembly 34 can be removed from the surgical site.
  • the tab 74 of the surgical buttress 70 is freed from the protrusion 62 by cutting of the buttress retention band 80, and the pocket 76 of the surgical buttress 70 is freed from the cartridge tip 60 by tearing of the pocket 76 along the perforations 79 as the surgical buttress 70 pulls away from the staple cartridge 54.
  • the used staple cartridge 54 may then be removed from the tool assembly 34 and replaced with a new staple cartridge 54.
  • a new surgical buttress 70 may be installed onto the staple cartridge assembly 50, as needed or desired, as described above.
  • the surgical buttress 70 and a buttress retention band 180 may be assembled together prior to securing the surgical buttress 70 to the staple cartridge assembly 50 (FIG. 3).
  • the buttress retention band 180 is substantially the same as the buttress retention band 80 of FIG. 3, except that the elongate body 182 is free of barbs. It should be understood, however, that the buttress retention band 180 may include barbs along a portion or the entirety thereof.
  • the buttress retention band 180 is pre-threaded or weaved through the tab 72 of the surgical buttress 70 such that when the surgical buttress 70 is loaded onto the staple cartridge assembly 50, the tab 72 and the buttress retention band 180 are in registration with the protrusion 62 (FIG.
  • the first end 182a of the elongate body 182 includes a knot that tightens as the second end 182b is pulled therethrough and, in some other aspects, the buttress retention band 180 may be tied after tightening of the loop 184.
  • a surgical buttress attachment assembly 3 includes the anvil assembly 40, a surgical buttress 170, and a buttress retention band 80.
  • the surgical buttress assembly 3 may be used in addition or as an alternative to the surgical buttress assembly 2 (FIG. 3) on the surgical stapling apparatus 1 (FIG. 1).
  • the anvil assembly 40 has a central longitudinal slot 41 formed in the anvil plate 42 and a plurality of staple forming pockets or cavities 43 defined in an inward or tissue facing surface thereof 46.
  • An anvil tip 48 extends distal to the staple forming pockets 43.
  • a proximal portion 42a of the anvil plate 42 which extends proximally of the staple forming pockets 43, includes a projection 62 configured to secure a proximal end portion 170a of the surgical buttress 170 thereto.
  • the surgical buttress 170 is substantially the same as the surgical buttress 70 of FIG.
  • both the anvil and staple cartridge assemblies 40, 50 include a projection 62
  • the projections 62 are disposed adjacent to each other in longitudinally spaced relation so as not to interfere with opening and closing of the first and second jaw members 34a, 34b (FIG. 1).
  • the loading unit 30 may be configured to be detachably coupleable and controllable by a handheld electromechanical surgical device, such as the handheld electromechanical surgical system shown and described in U.S. Patent Appl. Pub. No. 2016/0310134, the entire content of which is incorporated herein by reference.
  • the loading unit 30 may be configured to detachably coupleable and controllable by a robotic surgical system, such as the robotic surgical system shown and described in U.S. Patent Appl. Pub. No. 2012/0116416, the entire content of which is incorporated herein by reference.

Abstract

A surgical stapling apparatus includes a loading unit, a surgical buttress, and a buttress retention band. The loading unit includes an anvil assembly and a staple cartridge assembly. The staple cartridge assembly includes a staple cartridge having a tissue facing surface including staple pockets and a central longitudinal slot defined therethrough, and a protrusion extending outwardly therefrom. The surgical buttress includes a proximal end portion and a distal end portion. The proximal end portion is positioned over the protrusion of the staple cartridge. The buttress retention band is disposed around the proximal end portion of the surgical buttress and the protrusion of the staple cartridge to releasably secure the proximal end portion of the surgical buttress to the staple cartridge assembly.

Description

BUTTRESS ATTACHMENT FOR SURGICAL STAPLING APPARATUS
FIELD
[0001] The present application is generally related to surgical stapling apparatus, and more particularly, to surgical buttress attachment assemblies for releasably securing surgical buttresses to the surgical stapling apparatus.
BACKGROUND
[0002] Surgical stapling apparatus are employed by surgeons to sequentially or simultaneously apply one or more rows of fasteners, e.g., staples or two-part fasteners, to body tissue for the purpose of joining segments of body tissue together. Such apparatus generally include a pair of jaws or finger-like structures between which the body tissue to be joined is placed. When the surgical stapling apparatus is actuated, or “fired”, longitudinally moving firing bars contact staple drive members in one of the jaws. The staple drive members push the surgical staples through the body tissue and into an anvil in the opposite jaw which forms the staples. If body tissue is to be removed or separated, a knife blade can be provided in the jaws of the apparatus to cut the body tissue between the lines of staples.
[0003] Surgical supports, e.g., meshes or buttress materials, may be used in combination with surgical stapling apparatus to bridge, repair, and/or reinforce tissue defects within a patient. A clinician may manually attach the buttress materials to the surgical stapling apparatus in the operating room during a surgical procedure, or utilize a surgical stapling apparatus including buttress materials pre-installed thereon, e.g., by an expensive automated attachment process. The buttress material reinforces the staple or suture line as well as covers the juncture of the body tissues to reduce leakage prior to healing.
SUMMARY
[0004] The present disclosure relates to buttress material attachment onto a surgical stapling apparatus. Surgical buttress attachment assemblies of this disclosure are designed to make surgical buttress attachment in the operating room a simple, straightforward, and cost-effective procedure. [0005] In one aspect, the present disclosure provides a surgical stapling apparatus including a loading unit, a surgical buttress, and a buttress retention band. The loading unit includes an anvil assembly and a staple cartridge assembly. The staple cartridge assembly includes a staple cartridge having a tissue facing surface including staple pockets and a central longitudinal slot defined therethrough, and a protrusion extending outwardly therefrom. The surgical buttress includes a proximal end portion and a distal end portion. The proximal end portion is positioned over the protrusion of the staple cartridge. The buttress retention band is disposed around the proximal end portion of the surgical buttress and the protrusion of the staple cartridge to releasably secure the proximal end portion of the surgical buttress to the staple cartridge assembly.
[0006] The protrusion of the staple cartridge may be disposed proximal to the staple pockets defined in the tissue facing surface of the staple cartridge. The protrusion may include sidewalls extending outwardly from the tissue facing surface and a platform raised off the tissue facing surface. In some aspects, the proximal end portion of the surgical buttress has a width that is the same as a width of the platform of the protrusion. The protrusion may include a groove extending around a periphery thereof, and the buttress retention band may be disposed within the groove. The protrusion may have a split body including first and second body halves disposed on opposed sides of the central longitudinal slot of the staple cartridge.
[0007] The proximal end portion of the surgical buttress may be a tab extending proximally from a body of the surgical buttress. The distal end portion of the surgical buttress may be a pocket extending distally from a body of the surgical buttress, and the staple cartridge may include a cartridge tip disposed within the pocket to releasably secure the distal end portion of the surgical buttress to the staple cartridge assembly. The pocket may include perforations defined therein. The perforations may be aligned with the central longitudinal slot of the staple cartridge.
[0008] The buttress retention band may include an elongate body having first and second ends. The first end may be slidably coupled onto the elongate body to form a loop encircling the proximal end portion of the surgical buttress and the protrusion of the staple cartridge. The first end of the elongate body may include an aperture through which the second end of the elongate body is threaded. The elongate body may include barbs. The buttress retention band may be threaded through the proximal end portion of the surgical buttress to form a loop around the proximal end portion.
[0009] The anvil assembly may include an anvil plate having a tissue facing surface including staple forming pockets and a central longitudinal slot defined therethrough, and a protrusion extending outwardly therefrom. In some aspects, the surgical stapling apparatus further includes a second surgical buttress and a second buttress retention band. The second surgical buttress includes a proximal end portion and a distal end portion. The proximal end portion is positioned over the protrusion of the anvil plate. The second buttress retention band is disposed around the proximal end portion of the second surgical buttress and the protrusion of the anvil plate to releasably secure the proximal end portion of the second surgical buttress to the anvil assembly. The protrusions of the anvil and staple cartridge assemblies may be disposed proximal to the staple forming pockets and the staple pockets.
[0010] The distal end portion of the second surgical buttress may include a pocket, and the anvil assembly may include an anvil tip disposed within the pocket to releasably secure the distal end portion of the second surgical buttress to the anvil assembly.
[0011] In another aspect, this disclosure provides a surgical buttress attachment assembly including a staple cartridge, a surgical buttress, and a buttress retention band. The staple cartridge has a tissue facing surface including staple pockets and a central longitudinal slot defined therethrough, and a protrusion extending outwardly therefrom. The surgical buttress includes a proximal end portion and a distal end portion. The proximal end portion is positioned over the protrusion of the staple cartridge. The buttress retention band is disposed around the proximal end portion of the surgical buttress and the protrusion of the staple cartridge to releasably secure the proximal end portion of the surgical buttress to the staple cartridge.
[0012] The distal end portion of the surgical buttress may include a pocket and the staple cartridge may include a cartridge tip disposed within the pocket to releasably secure the distal end portion of the surgical buttress to the staple cartridge. [0013] The details of one or more aspects of this disclosure are set forth in the accompanying drawings and the description below. Other aspects, as well as features, objects, and advantages of the aspects described in this disclosure will be apparent from the description and drawings, and from the claims.
BRIEF DESCRIPTION OF DRAWINGS
[0014] Various aspects of the present disclosure are described hereinbelow with reference to the drawings, which are incorporated in and constitute a part of this specification, wherein:
[0015] FIG. 1 is a perspective view of a surgical stapling apparatus in accordance with an aspect of the present disclosure;
[0016] FIG. 2 is a close-up view of the area of detail 2 indicated in FIG. 1, showing a tool assembly of the surgical stapling apparatus;
[0017] FIG. 3 is a perspective view, with parts separated, of a surgical buttress attachment assembly including a surgical buttress, a buttress retention band, and a staple cartridge assembly of the surgical stapling apparatus of FIG. 1 ;
[0018] FIG. 4 is a close-up view of the area of detail 4 indicated in FIG. 3, showing a proximal end portion of the staple cartridge assembly;
[0019] FIG. 5 is a cross-sectional view of the surgical buttress of FIG. 3, taken along section line 5-5 of FIG. 3;
[0020] FIG. 6 is a front view of the buttress retention band of FIG. 3;
[0021] FIG. 7 is a perspective view of a proximal end portion of the staple cartridge assembly of FIG. 3, shown with the surgical buttress secured to the staple cartridge by the buttress retention band;
[0022] FIG. 8 is a perspective view of the proximal end portion of the staple cartridge assembly of FIG. 7, shown during a firing stroke of the surgical stapling apparatus; [0023] FIG. 9 is a perspective view of a surgical buttress and a buttress retention band in accordance with another aspect of the present disclosure; and
[0024] FIG. 10 is a bottom, perspective view of a surgical buttress attachment assembly including a surgical buttress, a buttress retention band, and an anvil assembly in accordance with another aspect of the present disclosure.
DETAILED DESCRIPTION
[0025] Aspects of the present disclosure will now be described in detail with reference to the drawing figures wherein like reference numerals identify similar or identical elements. Throughout this description, the term “proximal” refers to a portion of a structure, or component thereof, that is closer to a user, and the term “distal” refers to a portion of the structure, or component thereof, that is farther from the user.
[0026] Referring now to FIG. 1, an exemplary surgical stapling apparatus or surgical stapler 1 is shown for use in stapling tissue in accordance with aspects of the present disclosure. The surgical stapling apparatus 1 generally includes a handle assembly 10, an elongate tubular body 20 extending distally from the handle assembly 10, and a loading unit 30 extending distally from the elongate tubular body 20. The loading unit 30 includes a housing portion 32 and a tool or jaw assembly 34 including first and second jaw members 34a, 34b. The first jaw member 34a and/or the second jaw members 34b is pivotable with respect to the housing portion 32 such that the tool assembly 34 is movable between an open position in which the first and second jaw members 34a, 34b are spaced apart with respect to each other, and a closed position in which the first and second jaw members 34a, 34b are substantially adjacent each other.
[0027] The handle assembly 10 includes a stationary handle member 12a, a movable handle member 12b, and a barrel portion 14. Actuation of the movable handle member 12b applies lines of staples to tissue captured between the first and second jaw members 34a, 34b of the tool assembly 34. An articulation lever 16 is mounted on the forward end of the barrel portion 14 to facilitate articulation of the tool assembly 34. A rotatable member 18 is also mounted on the forward end of the barrel portion 14, adjacent the articulation lever 16. Rotation of the rotatable member 18 relative to the barrel portion 14 rotates the elongate tubular body 20 and the loading unit 30 relative to the handle assembly 10 so as to properly orient the tool assembly 34 relative to tissue to be stapled. A knob 19 is movably positionable along the barrel portion 14. The knob 19 is advanced distally to approximate or close the first and second jaw members 34a, 34b of the tool assembly 34 relative to each other, and retracted proximally to unapproximate or open the first and second jaw members 34a, 34b of the tool assembly 34 with respect to each other.
[0028] The loading unit 30 is a disposable loading unit (“DLU”) that is releasably secured to the elongated tubular body 20 and thus, replaceable with a new loading unit 30. The loading unit 30 may be a single use loading unit (“SULU”) that is used one time and then replaced to facilitate multiples uses of the surgical stapling apparatus 1 on a patient. For example, during a surgical procedure, the surgical stapling apparatus 1 can be used to staple and cut tissue, and the entire SULU is replaced after each staple and cut operation of the surgical stapling apparatus 1. The loading unit 30 may be a multi-use loading unit (“MULU”) that is re-useable a predetermined number of times. For example, during a surgical procedure, the surgical stapling apparatus 1 can be used to staple and cut tissue, and a reload assembly (e.g., a staple cartridge 54 as seen in FIG. 2) of the MULU is replaced after each staple and cut operation of the surgical stapling apparatus 1 a pre-determined number of times before the entire MULU needs to be replaced. Alternatively, the loading unit 30 may be permanently affixed to the elongated tubular body 20.
[0029] As shown in FIGS. 1 and 2, the first jaw member 34a of the tool assembly 34 includes an anvil assembly 40 and the second jaw member 34b of the tool assembly 34 includes a staple cartridge assembly 50. The anvil assembly 40 includes an anvil plate 42 and a cover plate 44 secured over the anvil plate 42. The staple cartridge assembly 50 includes a cartridge carrier 52 and a staple cartridge 54 selectively received and supported within the cartridge carrier 52. The staple cartridge 54 may be removably and/or replaceably attached to the cartridge carrier 52 by, for example, a snap-fit connection, a detent, a latch, among other types of connectors within the purview of those skilled in the art.
[0030] For a detailed description of the structure and function of exemplary surgical stapling apparatus, reference may be made to U.S. Patent Nos. 6,241,139, 6,330,965, and 7,819,896, the entire contents of each of which are incorporated herein by reference. It should be appreciated that principles of the present disclosure are equally applicable to surgical stapling apparatus having other configurations such as, for example, the types described in U.S. Patent Nos. 5,964,394, 7,128,253, and 7,334,717, the entire contents of each of which are incorporated herein by reference. Accordingly, it should be understood that a variety of surgical stapling apparatus may be utilized with aspects of the present disclosure. For example, laparoscopic or open staplers, such as, for example, GIA™, Endo GIA™, TA™, and Endo TA™ staplers and/or linear and radial reloads with, for example, Tri-Staple™ technology, available through Medtronic (North Haven, CT) may be utilized with aspects of the present disclosure.
[0031] Turning now to FIG. 3, a surgical buttress attachment assembly 2 of the surgical stapling apparatus 1 (FIG. 1) is shown. The surgical buttress attachment assembly 2 includes the staple cartridge assembly 50, a surgical buttress 70, and a buttress retention band 80.
[0032] The staple cartridge 54 of the staple cartridge assembly 50 includes a cartridge body 56 having an inward or tissue facing surface 58 defining staple pockets or retention slots 55 formed therein. A central longitudinal slot 57 is formed in and extends along a substantial length of the cartridge body 56 to facilitate passage of a knife blade 24 (FIG. 8) of a drive assembly 22 therethrough. A cartridge tip 60 extends axially from the cartridge body 56 distal to the staple pockets 55 and a protrusion 62 extends outwardly from the tissue facing surface 58 of the cartridge body 56 proximal to the staple pockets 55.
[0033] As shown in FIGS. 3 and 4, the protrusion 62 is a projection, bump, protuberance, etc. on the tissue facing surface 58 of the staple cartridge 54 to which a proximal end portion 70a of the surgical buttress 70 is releasably secured via the buttress retention band 80. The protrusion 62 has a split body including first and second body halves 62a, 62b disposed on opposed sides of the central longitudinal slot 57 of the staple cartridge 54 so that the protrusion 62 does not encumber travel of the knife blade 24 (FIG. 8) during a firing stroke of the surgical stapling apparatus 1 (FIG. 1). The protrusion 62 includes side walls 64 extending outwardly from the tissue facing surface 58 of the staple cartridge 54 towards the anvil assembly 40 (FIG. 2) and a platform 66 raised off of the tissue facing surface 58 and extending along a plane parallel to a plane defined by the tissue facing surface 58. A groove 65 is defined in the side walls 64 and extends around a periphery of the protrusion 62 (e.g., circumferentially therearound).
[0034] With continued reference to FIG. 3, the surgical buttress 70 includes a body 72 having a generally rectangular shape that is configured for positioning over the staple pockets 55 of the tissue facing surface 58 of the staple cartridge 54. A proximal end portion 70a of the surgical buttress 70 includes a tab 74 and a distal end portion 70b of the surgical buttress 70 includes a pocket 76. The tab 74 extends proximally from a proximal end 72a of the body 72 and is sized and shaped for positioning over the protrusion 62 on the tissue facing surface 58 of the staple cartridge 54. In aspects, the tab 74 has a width that is smaller than a width of the body 72 and, in some aspects, the tab 74 has a width that is substantially the same as a width of the protrusion 62 of the staple cartridge 54. In aspects, the tab 74 has a length that is longer than a length of the protrusion 62 such that the tab 74 covers the protrusion 62 along the length thereof.
[0035] As shown in FIGS. 3 and 5, the pocket 76 extends distally from a distal end 72b of the body 72 and is sized and shaped for positioning around the cartridge tip 60 of the staple cartridge 54. The pocket 76 has a proximally facing opening into a cavity 77 defined therein for receiving the cartridge tip 60. Perforations 79 are defined in the pocket 76 and extend along a plane coincident with the central longitudinal slot 57 of the staple cartridge 54 when the surgical buttress 70 is disposed on the staple cartridge assembly 50. In some aspects, the perforations 79 are disposed distal to the central longitudinal slot 57 of the staple cartridge 54 (e.g., only in the pocket 76 of the surgical buttress 70) and, in some other aspects, the perforations 79 are further defined in the body 72 of the surgical buttress 70 (e.g., in the distal end 72b of the body 72) and overlie a portion of the central longitudinal slot 57.
[0036] The surgical buttress 70 is fabricated from biocompatible materials which are bioabsorbable or non-absorbable, natural or synthetic materials. It should be understood that a single or combination of natural, synthetic, bioabsorbable, and/or non-bioabsorbable materials may be used to form the surgical buttress 70. In aspects, the surgical buttress 70 is a single sheet of material that is formed and cut to shape. In other aspects, the surgical buttress 70 is formed from a plurality of sheets of material, that are fabricated from the same or different materials, and/or the components (e.g., the body, the tab, the pocket, etc.) of the surgical buttress 70 are formed from the same or different materials that are attached to one another by, for example, welding, using adhesive, tying sutures, etc.
[0037] The surgical buttress 70 may be porous, non-porous, or combinations thereof. Suitable porous structures include, for example, fibrous structures (e.g., knitted structures, woven structures, and non-woven structures) and/or foams (e.g., open or closed cell foams). Suitable non-porous structures include, for example, films. The surgical buttress 70 may be a single porous or non-porous layer, or include a plurality of layers including any combination of porous and non-porous layers. For example, the surgical buttress 70 may include multiple porous and non-porous layers that are stacked in an alternating manner. In another example, the surgical buttress 70 may be formed in a “sandwich-like” manner wherein the outer layers are porous and the inner layer(s) are non-porous, or vice versa.
[0038] Porous layer(s) in the surgical buttress 70 may enhance the ability of the surgical buttress 70 to absorb fluid, reduce bleeding, and/or seal a wound. Also, the porous layer(s) may allow for tissue ingrowth to fix the surgical buttress 70 in place. Non-porous layer(s) in the surgical buttress 70 may enhance the ability of the surgical buttress 70 to resist tears and perforations during the manufacturing, shipping, handling, and/or stapling processes. Also, non-porous layer(s) may retard or prevent tissue ingrowth from surrounding tissues thereby acting as an adhesion barrier and preventing the formation of unwanted scar tissue.
[0039] As shown in FIGS. 3 and 6, the buttress retention band 80 has an elongate body
82 including first and second ends 82a, 82b. The elongate body 82 is formed from a length of material (e.g., a single, continuous structure, such as a suture, athread, a fiber, etc. having a monofilament or multifilament construction). The first end 82a of the elongate body 82 is slidably coupled onto the elongate body 82 to form a loop 84 defining an opening 85 therein that is adjustable in size. The first end 82a includes an aperture 83 through which the second end 82b is threaded. The second end 82b can be moved relative to the aperture
83 to adjust the size of the loop 84. The loop 84 is configured to encircle and grip the protrusion 62 of the staple cartridge 54.
[0040] The elongate body 82 includes barbs 86 along a majority thereof, with the first end 82a of the elongate body 82 being barbless to provide a surface to which the barbs 86 adhere and the second end 82b of the elongate body 82 also being barbless to provide a grasping portion for the user. The barbs 86 help facilitate locking of the loop 84 once adjusted to a desired sized and, in aspects, allows for one-way travel of the elongate body 82 through the first end 82a for adjusting the loop 84 to a smaller size. The barbs 86 may be single or compound and may be oriented in a unidirectional or bidirectional arrangement. For example, a barbed suture available commercially as V-LOC™ from Medtronic (North Haven, CT) may be utilized with aspects of the present disclosure . For a detailed description of the structure and function of exemplary sutures suitable for use as buttress retention bands, reference may be made to U.S. Patent Nos. 5,306,289 and 8,273,105, the entire contents of each of which are incorporated herein by reference. It should be understood that the buttress retention band may have other barb configurations, such as barbs along portion(s) or the entirety thereof. Alternatively, the buttress retention band may be barbless.
[0041] The buttress retention band 80 is formed from biocompatible materials which may be any combination of natural, synthetic, bioabsorbable, and/or non-bioabsorbable materials. In aspects, the buttress retention band 80 is formed from a biodegradable material such that any portion released into the body of a patient (e.g., fragments remaining with the surgical buttress 70 or cut after firing of the surgical stapling apparatus 1) does not need to be retrieved from the patient’s body. It is envisioned that the buttress retention band 80 may be formed from an elastic or stretchable material having a pre-formed, continuous loop biased in size to engage the protrusion 62 of the staple cartridge assembly 50, and stretchable during placement on the protrusion 62.
[0042] With continued reference to FIGS. 3-6, in a method of loading the surgical buttress 70 onto the staple cartridge assembly 50, the pocket 76 of the surgical buttress 70 is aligned with the cartridge tip 60 of the staple cartridge assembly 50 and slid thereover such that the cartridge tip 60 is received and retained within the cavity 77 defined in the pocket 76 of the surgical buttress 70, as seen in FIG. 2. The body 72 of the surgical buttress 70 is laid against the tissue facing surface 58 of the staple cartridge 54, with the tab 74 of the surgical buttress 70 aligned with and extending across the platform 66 of the protrusion 62 of the staple cartridge 54. The buttress retention band 80 is placed over the tab 74 of the surgical buttress 70 with the loop 84 encircling the tab 74 and the protrusion 62. The buttress retention band 80 is then tightened by pulling the second end 82b of the elongate body 82 to adjust the size of the loop 84 and to capture the tab 74 of the surgical buttress 70 onto the projection 62 of the staple cartridge 54, as seen in FIG. 7. In aspects, buttress retention band 80 is aligned with the groove 65 defined in the protrusion 62 such that the elongate body 82 is fixed within the groove 65 during tightening of the loop 84 to secure the buttress retention band 80 to the tab 74 and the projection 62.
[0043] Accordingly, the proximal end portion 70a of the surgical buttress 70 is retained on the staple cartridge assembly 50 by engagement of the tab 74 with the protrusion 62 via the buttress retention band 80 (FIG. 7), and the distal end portion 70b of the surgical buttress
70 is retained on the staple cartridge assembly 50 by engagement of the pocket 76 with the cartridge tip 60 (FIG. 2).
[0044] The surgical stapling apparatus 1 (FIG. 1), with the staple cartridge assembly 50 loaded with the surgical buttress 70, is ready for use. In aspects, as seen in FIG. 2, the anvil assembly 40 is pre-loaded and/or loaded with a surgical buttress 71. The surgical buttress
71 is retained on the anvil assembly 40 by any suitable attachment feature within the purview of those skilled in the art, such as, for example, mechanical attachment features (e.g., a suture as seen in FIG. 2), chemical attachment features (e.g., adhesive), and/or attachment methods (e.g., welding).
[0045] In operation, with the loading unit 30 loaded with the surgical buttress 70, as described above and shown in FIG. 1, the surgical stapling apparatus 1 is used in accordance with methods known by those skilled in the art. Once the anvil and staple cartridge assemblies 40, 50 are clamped onto tissue, the surgical stapling apparatus 1 is fired, thereby stapling the surgical buttress 70 to the tissue. As shown in FIG. 8, during firing, the knife blade 24 of the drive assembly 22, which is defined in a distal edge of an I-beam 26, travels distally through the central longitudinal slot 57 and substantially simultaneously cuts and divides the tissue and the surgical buttress 70 disposed between the rows of formed staples. Specifically, the knife blade 24 travels through the protrusion 62 and cuts the buttress retention band 80 thereby releasing the tab 74 from the protrusion 62. When firing is complete and the anvil and staple cartridge assemblies 40, 50 are unclamped, the surgical buttress 70, which is now stapled to the tissue, pulls away from the staple cartridge assembly 50, and the tool assembly 34 can be removed from the surgical site. Specifically, the tab 74 of the surgical buttress 70 is freed from the protrusion 62 by cutting of the buttress retention band 80, and the pocket 76 of the surgical buttress 70 is freed from the cartridge tip 60 by tearing of the pocket 76 along the perforations 79 as the surgical buttress 70 pulls away from the staple cartridge 54. The used staple cartridge 54 may then be removed from the tool assembly 34 and replaced with a new staple cartridge 54. A new surgical buttress 70 may be installed onto the staple cartridge assembly 50, as needed or desired, as described above.
[0046] As shown in FIG. 9, the surgical buttress 70 and a buttress retention band 180 may be assembled together prior to securing the surgical buttress 70 to the staple cartridge assembly 50 (FIG. 3). The buttress retention band 180 is substantially the same as the buttress retention band 80 of FIG. 3, except that the elongate body 182 is free of barbs. It should be understood, however, that the buttress retention band 180 may include barbs along a portion or the entirety thereof. The buttress retention band 180 is pre-threaded or weaved through the tab 72 of the surgical buttress 70 such that when the surgical buttress 70 is loaded onto the staple cartridge assembly 50, the tab 72 and the buttress retention band 180 are in registration with the protrusion 62 (FIG. 3) of the staple cartridge assembly 50 and can be tightened thereon. In some aspects, the first end 182a of the elongate body 182 includes a knot that tightens as the second end 182b is pulled therethrough and, in some other aspects, the buttress retention band 180 may be tied after tightening of the loop 184.
[0047] While the staple cartridge assembly 50 is shown as part of the surgical buttress retention assembly 2, it should be understood that the anvil assembly 40 may be part of a surgical buttress retention assembly. As shown in FIG. 10, a surgical buttress attachment assembly 3 includes the anvil assembly 40, a surgical buttress 170, and a buttress retention band 80. The surgical buttress assembly 3 may be used in addition or as an alternative to the surgical buttress assembly 2 (FIG. 3) on the surgical stapling apparatus 1 (FIG. 1).
[0048] As shown in FIG. 10, the anvil assembly 40 has a central longitudinal slot 41 formed in the anvil plate 42 and a plurality of staple forming pockets or cavities 43 defined in an inward or tissue facing surface thereof 46. An anvil tip 48 extends distal to the staple forming pockets 43. A proximal portion 42a of the anvil plate 42, which extends proximally of the staple forming pockets 43, includes a projection 62 configured to secure a proximal end portion 170a of the surgical buttress 170 thereto. The surgical buttress 170 is substantially the same as the surgical buttress 70 of FIG. 3, except that the pocket 176 is sized and shaped to accommodate the anvil tip 48, and the length of the body 172 and/or the tab 174 may vary depending upon the position of the protrusion 62 relative to the anvil tip 48. In aspects in which both the anvil and staple cartridge assemblies 40, 50 include a projection 62, the projections 62 are disposed adjacent to each other in longitudinally spaced relation so as not to interfere with opening and closing of the first and second jaw members 34a, 34b (FIG. 1).
[0049] While illustrated as being used on a hand-held manually actuated surgical device hereinabove, it is contemplated, and within the scope of the present disclosure for the loading unit 30 to be configured for use with various electromechanical surgical instruments and/or electrosurgical instruments. For example, the loading unit 30 may be configured to be detachably coupleable and controllable by a handheld electromechanical surgical device, such as the handheld electromechanical surgical system shown and described in U.S. Patent Appl. Pub. No. 2016/0310134, the entire content of which is incorporated herein by reference. As another example, the loading unit 30 may be configured to detachably coupleable and controllable by a robotic surgical system, such as the robotic surgical system shown and described in U.S. Patent Appl. Pub. No. 2012/0116416, the entire content of which is incorporated herein by reference.
[0050] While aspects of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. It is to be understood, therefore, that the disclosure is not limited to the precise aspects described, and that various other changes and modifications may be effected by one skilled in the art without departing from the scope or spirit of the disclosure. Additionally, the elements and features shown and described in connection with certain aspects of the disclosure may be combined with the elements and features of certain other aspects without departing from the scope of the present disclosure, and that such modifications and variation are also included within the scope of the present disclosure. Therefore, the above description should not be construed as limiting, but merely as exemplifications of aspects of the disclosure. Thus, the scope of the disclosure should be determined by the appended claims and their legal equivalents, rather than by the examples given.

Claims

WHAT IS CLAIMED IS:
1. A surgical stapling apparatus comprising: a loading unit including an anvil assembly and a staple cartridge assembly, the staple cartridge assembly including a staple cartridge having a tissue facing surface including staple pockets and a central longitudinal slot defined therethrough and a protrusion extending outwardly therefrom; a surgical buttress including a proximal end portion and a distal end portion, the proximal end portion positioned over the protrusion of the staple cartridge; and a buttress retention band disposed around the proximal end portion of the surgical buttress and the protrusion of the staple cartridge to releasably secure the proximal end portion of the surgical buttress to the staple cartridge assembly.
2. The surgical stapling apparatus according to claim 1, wherein the protrusion is disposed proximal to the staple pockets defined in the tissue facing surface of the staple cartridge.
3. The surgical stapling apparatus according to claim 1, wherein the protrusion includes sidewalls extending outwardly from the tissue facing surface and a platform raised off the tissue facing surface.
4. The surgical stapling apparatus according to claim 3, wherein the proximal end portion of the surgical buttress has a width that is the same as a width of the platform of the protrusion.
5. The surgical stapling apparatus according to claim 1, wherein the protrusion includes a groove extending around a periphery thereof, and the buttress retention band is disposed within the groove.
6. The surgical stapling apparatus according to claim 1, wherein the protrusion has a split body including first and second body halves disposed on opposed sides of the central longitudinal slot of the staple cartridge.
7. The surgical stapling apparatus according to claim 1, wherein the proximal end portion of the surgical buttress is a tab extending proximally from a body of the surgical buttress.
8. The surgical stapling apparatus according to claim 1, wherein the distal end portion of the surgical buttress is a pocket extending distally from a body of the surgical buttress, and the staple cartridge includes a cartridge tip disposed within the pocket to releasably secure the distal end portion of the surgical buttress to the staple cartridge assembly.
9. The surgical stapling apparatus according to claim 8, wherein the pocket includes perforations defined therein, the perforations aligned with the central longitudinal slot of the staple cartridge.
10. The surgical stapling apparatus according to claim 1, wherein the buttress retention band includes an elongate body having first and second ends, the first end slidably coupled onto the elongate body to form a loop encircling the proximal end portion of the surgical buttress and the protrusion of the staple cartridge.
11. The surgical stapling apparatus according to claim 10, wherein the first end of the elongate body includes an aperture through which the second end of the elongate body is threaded.
12. The surgical stapling apparatus according to claim 10, wherein the elongate body includes barbs.
13. The surgical stapling apparatus according to claim 1, wherein the buttress retention band is threaded through the proximal end portion of the surgical buttress to form a loop around the proximal end portion.
14. The surgical stapling apparatus according to claim 1, wherein the anvil assembly includes an anvil plate having a tissue facing surface including staple forming pockets and a central longitudinal slot defined therethrough and a protrusion extending outwardly therefrom, and the surgical stapling apparatus further comprises: a second surgical buttress including a proximal end portion and a distal end portion, the proximal end portion positioned over the protrusion of the anvil plate; and a second buttress retention band disposed around the proximal end portion of the second surgical buttress and the protrusion of the anvil plate to releasably secure the proximal end portion of the second surgical buttress to the anvil assembly.
15. The surgical stapling apparatus according to claim 14, wherein the protrusions of the anvil and staple cartridge assemblies are disposed proximal to the staple forming pockets and the staple pockets.
16. The surgical stapling apparatus according to claim 14, wherein the distal end portion of the second surgical buttress includes a pocket, and the anvil assembly includes an anvil tip disposed within the pocket to releasably secure the distal end portion of the second surgical buttress to the anvil assembly.
17. A surgical buttress attachment assembly comprising: a staple cartridge having a tissue facing surface including staple pockets and a central longitudinal slot defined therethrough and a protrusion extending outwardly therefrom; a surgical buttress including a proximal end portion and a distal end portion, the proximal end portion positioned over the protrusion of the staple cartridge; and a buttress retention band disposed around the proximal end portion of the surgical buttress and the protrusion of the staple cartridge to releasably secure the proximal end portion of the surgical buttress to the staple cartridge.
18. The surgical buttress attachment assembly according to claim 17, wherein the distal end portion of the surgical buttress includes a pocket, and the staple cartridge includes a cartridge tip disposed within the pocket to releasably secure the distal end portion of the surgical buttress to the staple cartridge.
EP22740961.2A 2021-06-23 2022-06-16 Buttress attachment for surgical stapling apparatus Pending EP4358864A1 (en)

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